Baseline characteristics
| Variables | All patients, n=442 | Surgical AVR, n=351 | Unoperated, n=91 | p Value |
| Demography | ||||
| Mean age, years | 74±11 | 73±10 | 81±9 | <0.0001 |
| Male sex, n (%) | 249 (56) | 205 (58) | 44 (48) | 0.085 |
| Married or partner, n (%) | 270 (65) | 223 (67) | 47 (58) | 0.139 |
| Body mass index, kg/m² | 26±5 | 26±4 | 25±5 | <0.0001 |
| Medical history, n (%) | ||||
| Hypertension | 202 (46) | 162 (46) | 40 (44) | 0.708 |
| Heart failure | 28 (6) | 17 (5) | 11 (12) | 0.011 |
| Atrial fibrillation, all types | 94 (21) | 65 (19) | 29 (32) | <0.006 |
| Diabetes mellitus type I and II | 48 (11) | 31 (9) | 17 (19) | <0.007 |
| Pulmonary disease | 77 (17) | 57 (16) | 20 (22) | 0.198 |
| Kidney disease | 25 (6) | 15 (4) | 10 (11) | 0.013 |
| Coronary artery disease | 131 (30) | 106 (30) | 25 (27) | 0.612 |
| Clinical findings | ||||
| Systolic blood pressure, mm Hg | 143±22 | 144±22 | 139±24 | 0.057 |
| Diastolic blood pressure, mm Hg | 77±12 | 77±12 | 74±13 | 0.026 |
| Heart rate, beats/min | 73±13 | 73±13 | 74±13 | 0.398 |
| Medication, n (%) | ||||
| Beta-blocker | 206 (47) | 157 (45) | 49 (54) | 0.120 |
| ACE inhibitor/ARB | 178 (40) | 135 (38) | 43 (47) | 0.262 |
| Calcium antagonist | 89 (20) | 71 (20) | 18 (20) | 0.924 |
| Statin | 233 (53) | 192 (55) | 41 (46) | 0.101 |
| Diuretic | 165 (37) | 107 (30) | 58 (64) | <0.0001 |
| Warfarin | 90 (20) | 61 (17) | 29 (32) | 0.002 |
| Platelet inhibitor | 231 (52) | 190 (54) | 41 (45) | 0.122 |
| Digitalis | 31 (7) | 19 (5) | 12 (13) | 0.010 |
| Charlson Comorbidity Index, n (%) | <0.0001 | |||
| 0 | 177 (40) | 150 (43) | 27 (30) | |
| 1–2 | 213 (48) | 170 (48) | 43 (47) | |
| ≥3 | 52 (12) | 31 (9) | 21 (23) | |
| Surgical risk score | ||||
| Euro(II)SCORE, median ± IQR | 2 (1–4) | 2 (1–4) | 4 (2–8) | <0.0001 |
| NYHA classification, n (%) | <0.0001 | |||
| Class I | 48 (11) | 21 (6) | 27 (30) | |
| Class II | 205 (46) | 176 (50) | 29 (32) | |
| Class III/IV | 189 (43) | 154 (44) | 35 (38) | |
| CCS grade, n (%) | 0.002 | |||
| Score 0 | 251 (57) | 186 (53) | 65 (71) | |
| Score 1–2 | 163 (37) | 144 (41) | 19 (21) | |
| Score 3–4 | 28 (6) | 21 (6) | 7 (8) | |
| Echocardiographic measures | ||||
| SWTd, cm | 1.1±0.2 | 1.1±0.2 | 1.1±0.2 | 0.472 |
| LVIDd, cm | 5.0±0.6 | 5.0±0.6 | 4.9±0.6 | 0.153 |
| PWTd, cm | 0.9±0.1 | 0.9±0.1 | 0.9±0.1 | 0.504 |
| LVEF, % | 56.2±9.2 | 56.4±8.6 | 55.1±11.2 | 0.227 |
| Cardiac output, L/min | 4.9±1.2 | 4.9±1.2 | 4.6±1.3 | 0.034 |
| Aortic peak velocity, m/s | 4.7±0.8 | 4.7±0.8 | 4.5±0.7 | 0.021 |
| Aortic mean gradient, mm Hg | 55±18 | 56±18 | 51±18 | 0.013 |
| Aortic valve area, cm² | 0.7±0.2 | 0.7±0.2 | 0.7±0.2 | 0.253 |
| Biochemical values | ||||
| Haemoglobin, g/dL | 13.6±1.6 | 13.8±1.5 | 13.1±1.9 | 0.0004 |
| Blood platelets, 109/L | 251±70 | 251±68 | 248±79 | 0.668 |
| hs-CRP, mg/L | 5.1±9 | 4.7±8 | 6.6±12 | 0.085 |
| HbA1c, % | 5.9±0.8 | 5.9±0.7 | 6.0±1.0 | 0.186 |
| Creatinine, µmol/L | 87±29 | 85±28 | 93±31 | 0.027 |
| eGFR, mL/min | 74±33 | 78±32 | 58±29 | <0.0001 |
| NT-pro-BNP, pmol/L, median (IQR) | 91 (33–234) | 71 (30–178) | 192 (58–402) | <0.0001 |
| hs-TnT, ng/mL, median (IQR) | 14 (10–25) | 12 (10–22) | 19 (12–38) | <0.0001 |
| Quality of life | ||||
| Summary PCS | 39±11 | 39±10 | 36±13 | 0.009 |
| Summary MCS | 50±11 | 50±11 | 48±14 | 0.337 |
| EQ-5D UK index score | 0.72±0.22 | 0.73±0.21 | 0.65±0.27 | 0.001 |
| EQ-VAS score | 59±22 | 60±21 | 56±24 | 0.090 |
| 6-Min walk test, m | 446±133 | 460±127 | 374±144 | <0.0001 |
| MMSE score | 28.1±2.4 | 28.4±2.0 | 27.0±3.5 | <0.0001 |
Plus–minus values are means±SD. p Values for comparison between operated and unoperated patients.
ARB, angiotensin receptor blocker; AVR, aortic valve replacement; CCS, Canadian Cardiovascular Society; eGFR, estimated glomerular filtration rate (Cockcroft-Gault formula); EQ-5D UK, EuroQol 5-Dimension United Kingdom; Euro(II)SCORE, European System for Cardiac Operative Risk Evaluation; HbA1c, haemoglobin A1c; EQ-VAS, EuroQol visual analogue scale; hs-CRP, high-sensitive C-reactive protein; hs-TnT, high-sensitive troponin T; LVEF, left ventricular ejection fraction; LVIDd, left ventricular internal dimension at end diastole; MCS, Mental Component Summary; MMSE, Mini-Mental State Examination; NT-proBNP, N-terminal pro-brain natriuretic peptide; NYHA, New York Heart Association; PCS, Physical Component Summary; PWTd, posterior wall thickness at end-diastole; SWTd, septal wall thickness at end-diastole.